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Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study

BACKGROUND: While most individuals wish to die at home, the reality is that most will die in hospital. AIM: To determine whether receiving a physician home visit near the end-of-life is associated with lower odds of death in a hospital. DESIGN: Observational retrospective cohort study, examining loc...

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Autores principales: Tanuseputro, Peter, Beach, Sarah, Chalifoux, Mathieu, Wodchis, Walter P., Hsu, Amy T., Seow, Hsien, Manuel, Douglas G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813907/
https://www.ncbi.nlm.nih.gov/pubmed/29447291
http://dx.doi.org/10.1371/journal.pone.0191322
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author Tanuseputro, Peter
Beach, Sarah
Chalifoux, Mathieu
Wodchis, Walter P.
Hsu, Amy T.
Seow, Hsien
Manuel, Douglas G.
author_facet Tanuseputro, Peter
Beach, Sarah
Chalifoux, Mathieu
Wodchis, Walter P.
Hsu, Amy T.
Seow, Hsien
Manuel, Douglas G.
author_sort Tanuseputro, Peter
collection PubMed
description BACKGROUND: While most individuals wish to die at home, the reality is that most will die in hospital. AIM: To determine whether receiving a physician home visit near the end-of-life is associated with lower odds of death in a hospital. DESIGN: Observational retrospective cohort study, examining location of death and health care in the last year of life. SETTING/PARTICIPANTS: Population-level study of Ontarians, a Canadian province with over 13 million residents. All decedents from April 1, 2010 to March 31, 2013 (n = 264,754) RESULTS: More than half of 264,754 decedents died in hospital: 45.7% died in an acute care hospital and 7.7% in complex continuing care. After adjustment for multiple factors–including patient illness, home care services, and days of being at home–receiving at least one physician home visit from a non-palliative care physician was associated with a 47% decreased odds (odds-ratio, 0.53; 95%CI: 0.51–0.55) of dying in a hospital. When a palliative care physician specialist was involved, the overall odds declined by 59% (odds ratio, 0.41; 95%CI: 0.39–0.43). The same model, adjusting for physician home visits, showed that receiving palliative home care was associated with a similar reduction (odds ratio, 0.49; 95%CI: 0.47–0.51). CONCLUSION: Location of death is strongly associated with end-of-life health care in the home. Less than one-third of the population, however, received end-of-life home care or a physician visit in their last year of life, revealing large room for improvement.
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spelling pubmed-58139072018-03-02 Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study Tanuseputro, Peter Beach, Sarah Chalifoux, Mathieu Wodchis, Walter P. Hsu, Amy T. Seow, Hsien Manuel, Douglas G. PLoS One Research Article BACKGROUND: While most individuals wish to die at home, the reality is that most will die in hospital. AIM: To determine whether receiving a physician home visit near the end-of-life is associated with lower odds of death in a hospital. DESIGN: Observational retrospective cohort study, examining location of death and health care in the last year of life. SETTING/PARTICIPANTS: Population-level study of Ontarians, a Canadian province with over 13 million residents. All decedents from April 1, 2010 to March 31, 2013 (n = 264,754) RESULTS: More than half of 264,754 decedents died in hospital: 45.7% died in an acute care hospital and 7.7% in complex continuing care. After adjustment for multiple factors–including patient illness, home care services, and days of being at home–receiving at least one physician home visit from a non-palliative care physician was associated with a 47% decreased odds (odds-ratio, 0.53; 95%CI: 0.51–0.55) of dying in a hospital. When a palliative care physician specialist was involved, the overall odds declined by 59% (odds ratio, 0.41; 95%CI: 0.39–0.43). The same model, adjusting for physician home visits, showed that receiving palliative home care was associated with a similar reduction (odds ratio, 0.49; 95%CI: 0.47–0.51). CONCLUSION: Location of death is strongly associated with end-of-life health care in the home. Less than one-third of the population, however, received end-of-life home care or a physician visit in their last year of life, revealing large room for improvement. Public Library of Science 2018-02-15 /pmc/articles/PMC5813907/ /pubmed/29447291 http://dx.doi.org/10.1371/journal.pone.0191322 Text en © 2018 Tanuseputro et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Tanuseputro, Peter
Beach, Sarah
Chalifoux, Mathieu
Wodchis, Walter P.
Hsu, Amy T.
Seow, Hsien
Manuel, Douglas G.
Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study
title Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study
title_full Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study
title_fullStr Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study
title_full_unstemmed Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study
title_short Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study
title_sort associations between physician home visits for the dying and place of death: a population-based retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813907/
https://www.ncbi.nlm.nih.gov/pubmed/29447291
http://dx.doi.org/10.1371/journal.pone.0191322
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